I just had a surgical excision and very much living in regret. I left a pin hole, ice pick scar for now a large gash across my cheek. Since then, I have had to get fillers in my cheek twice to prop it up as the gash was so large, maybe a lack of collagen on my part, so I had a gash AND a dent. What I would do to go back in time. My next step is CO2 laser to smooth over the discoloration and try to generate collagen back into the area and smooth the gash over. Living in a nightmare. Biggest advice, do the most non-invasive procedures before going under the knife. I should have tried TCA cross for a pinhole, but I just kept thinking that my hole would then get bigger - I have very thin skin. Acid in a hole felt in my mind somewhat counterintuitive to undertake. I am now trying to mentally, emotionally and physically recover. Oh and other advice, go to an ACNE SCAR SPECIALIST> My mistake was going to the best plastic surgeon in our area, but he is well-known for tummy tucks, breast augmentation, and rhinoplasty. He is not that familiar with acne scarring in particular and facial. I feel he did a huge 'hack' job on my cheek - hard to hide it. Now, next procedure - CO2, wish me luck...

2 minutes ago, perfectskin_dreamer said:

I just had a surgical excision and very much living in regret. I left a pin hole, ice pick scar for now a large gash across my cheek. Since then, I have had to get fillers in my cheek twice to prop it up as the gash was so large, maybe a lack of collagen on my part, so I had a gash AND a dent. What I would do to go back in time. My next step is CO2 laser to smooth over the discoloration and try to generate collagen back into the area and smooth the gash over. Living in a nightmare. Biggest advice, do the most non-invasive procedures before going under the knife. I should have tried TCA cross for a pinhole, but I just kept thinking that my hole would then get bigger - I have very thin skin. Acid in a hole felt in my mind somewhat counterintuitive to undertake. I am now trying to mentally, emotionally and physically recover. Oh and other advice, go to an ACNE SCAR SPECIALIST> My mistake was going to the best plastic surgeon in our area, but he is well-known for tummy tucks, breast augmentation, and rhinoplasty. He is not that familiar with acne scarring in particular and facial. I feel he did a huge 'hack' job on my cheek - hard to hide it. Now, next procedure - CO2, wish me luck...

Hi so sorry to hear what has happened to you, could you send photos if possible either personally pm me or postin the forum. Also was this a punch excision or a surgical blade subcision. Also how many layers of stitching did you get and did you use tape and steristrips to reduce tension in the healing process. I know I sound a bit needy and dont want to rub salt in the cut to your bad experience. But as much information as possible would really aid making it clearer for people in the future to embark on these procedures.

So, it was surgical eliptical excision - freehand, put all my trust in the doctor. Yes, for a pinhole/ice pick from the beginning should have gone with a punch excision to get to the depth. Sorry, not taking any photos these days - not even with my family or friends or I show a profile shot of my good side. Just not in the mental place to show anyone. He absolutely should have done under stitches and top stitches if he knew how to minimize scarring and indentation. Again, I went to someone who was a well-reknowned expert in Plastic Surgey - top ratings, but do not think he was a facial reconstructive expert. Again, i think he did a hack job on me - one big gash - elipse excision across my cheek. - 6 normal stitches, bulky black - not a refined job, even my husband saw that right away. Again, I would absolutely go to a deep expert in facial surgery - reconstructive Plastic Surgeon. I know there was a better way to have minimized this. again, would do anything to go back in time - lost 6 months of my life just now so depressed about making this decision. I researched this doctor and read all the reviews - so glowing. But again, you MUST go to an expert in acne scarring and facial PS. Rough stitches on a tummy tuck is different than on someone's cheek. I am now in the hands of one of the most caring dermatologists and one of the two foremost experts in acne scarring in our area. He is trying to undo the damage - he had to do subcision + filler plus come back for another filler to just prop my cheek back up as it dented under the trauma of this gash on such a soft tissue area. I had a beautiful apple cheek with one deep pinhole - should have just left it alone. Next step that I look forward to is now several rounds of resurfacing with CO2 to get me to somehow look and get back to normal. Hope my story helps.

13 minutes ago, perfectskin_dreamer said:

So, it was surgical eliptical excision - freehand, put all my trust in the doctor. Yes, for a pinhole/ice pick from the beginning should have gone with a punch excision to get to the depth. Sorry, not taking any photos these days - not even with my family or friends or I show a profile shot of my good side. Just not in the mental place to show anyone. He absolutely should have done under stitches and top stitches if he knew how to minimize scarring and indentation. Again, I went to someone who was a well-reknowned expert in Plastic Surgey - top ratings, but do not think he was a facial reconstructive expert. Again, i think he did a hack job on me - one big gash - elipse excision across my cheek. - 6 normal stitches, bulky black - not a refined job, even my husband saw that right away. Again, I would absolutely go to a deep expert in facial surgery - reconstructive Plastic Surgeon. I know there was a better way to have minimized this. again, would do anything to go back in time - lost 6 months of my life just now so depressed about making this decision. I researched this doctor and read all the reviews - so glowing. But again, you MUST go to an expert in acne scarring and facial PS. Rough stitches on a tummy tuck is different than on someone's cheek. I am now in the hands of one of the most caring dermatologists and one of the two foremost experts in acne scarring in our area. He is trying to undo the damage - he had to do subcision + filler plus come back for another filler to just prop my cheek back up as it dented under the trauma of this gash on such a soft tissue area. I had a beautiful apple cheek with one deep pinhole - should have just left it alone. Next step that I look forward to is now several rounds of resurfacing with CO2 to get me to somehow look and get back to normal. Hope my story helps.

Did it healed closed with indent. If thats the case then do spot fully ablative laser on it. It would lift the area. Its wired after excision sometimes the area is a little bit sunken. Laser should help flatten it hopefully.
thats is why I always so for acne scarring. Acne scarring is a bit different as we remove the skin and then suture it thats is why you need to go to someone who does excisions for acne scars as he would have experience specifically related to acne scars and how they respond. Anyways excision should be reserved for deep scars but sure we can try non invasive things first

As it is the apple of the cheek, I needed to get filler in first to lift it up and now will do CO2 laser to help with the discoloration around the scar and the excision scar line. Hoping to smooth out the cheek now, blend it in. It looks like a small dark patch now. Grateful for my current derm for helping me.

Yes, I agree with everything he said.

7 minutes ago, perfectskin_dreamer said:

As it is the apple of the cheek, I needed to get filler in first to lift it up and now will do CO2 laser to help with the discoloration around the scar and the excision scar line. Hoping to smooth out the cheek now, blend it in. It looks like a small dark patch now. Grateful for my current derm for helping me.

 

back to the excision I know it was a difficult subject to talk about, but could you approximate the size of the excision and if you dont mind me asking you mention your family. Would you be able to tell me your age, as obviously a more invasive procedure its tough to heal from at an older age.

mid-40s - and yes collagen loss at this age and being so invasive - didn't think about the result. It is a one inch gash - was 6 stitches. If he ever told me how much he would cut or how big, never would have undertaken this.

3 minutes ago, perfectskin_dreamer said:

mid-40s - and yes collagen loss at this age and being so invasive - didn't think about the result. It is a one inch gash - was 6 stitches. If he ever told me how much he would cut or how big, never would have undertaken this.

I™m so deeply upset for you he did a approximately 25mm excision was this linear.

In my diagram below would you say this is how he went about with the scalpel. With the circle representing the original scar and the line surrounding it being where the scalpel went.

Hi again I™m sorry I™ve just read your own post and please don™t awnsers this if you don™t want to. Please remember that your beautiful and nobody at work will think twice about a scar everyone has a scar. Your significant other didnt fall in love with you cause you had clear skin they loved you for you and no little scar no matter how big and in the way you think it looks will change anyones perception of you. Please don™t stress or be ashamed, if anything it™s a beauty mark.

Lots of love for you over here don™t beat yourself up at all

That is so kind of you. Yes, have lost nights of sleep and have been quite miserable with the self-blame for 6 months now. Your drawing is perfect. It was a traumatic, way too big excision. He should have indicated how large this would be - I asked him very specifically do you think in doing this that I will look the same in terms of my unhappiness with a scar, better or worse. He said it would not be worse, just better or same happiness. I thought I could live with those odds. Never thought that my cheek would go into a complete dent - luckily for fillers! Now, looking forward to see what CO2 can do to the area. Because honestly now the whole area around it is dark, scarred and noticeable. It did not heal well in general, in my opinion. Think it was just such a big excision. I love seeing these great excisions and MOHS from skin cancer and people with big chunks of skin out that look great, and mine looks just awful.

And you are so right my husband is absolutely adoring, loving. It makes him sad to see me like this. The light has gone out over something that I chose to do. I have rarely had completely clear skin, so he definitely didn't fall in love with me for that. When I have had clear skin periods and lived with my scars, we have had a great time and I have had such life in me. It is when I have chosen to fix me and it goes awry that it takes that life out.

Me too had 3-4 scars excised on the LHS as shown in picture and left this...disastrous

as circled (can never get over it) made them 10 times worser

6 hours ago, Scarsmakemewanttodie said:

Hi so sorry to hear what has happened to you, could you send photos if possible either personally pm me or postin the forum. Also was this a punch excision or a surgical blade subcision. Also how many layers of stitching did you get and did you use tape and steristrips to reduce tension in the healing process. I know I sound a bit needy and dont want to rub salt in the cut to your bad experience. But as much information as possible would really aid making it clearer for people in the future to embark on these procedures.

Punch excision was pretty life changing for me tbh. Check out my thread and let me know if you have questions.

5 hours ago, Catharsis2018 said:

Punch excision was pretty life changing for me tbh. Check out my thread and let me know if you have questions.

Im looking to give it a go I was potentially looking at using a expert mole remover to dot excision as I beleive he would be better equipped with knowledge to removal a small peice of skin on the face

3 hours ago, Scarsmakemewanttodie said:

Im looking to give it a go I was potentially looking at using a expert mole remover to dot excision as I beleive he would be better equipped with knowledge to removal a small peice of skin on the face

Thats actually a great idea lol and quite smart of you. Further to that, I do suggest micro botox to be injected on top of the sutures. What are your type of scars and skin type?

Im blonde blue eyes skin type one so all ideal for treatments, I have a small scar that looks like a sploge of paint that sunken in due to it being a week scar tissue, then replace with small linear and because of my scar type a few co2 laser and it should be minimal and with the contour of my face. Let me know what you think.

14 minutes ago, Catharsis2018 said:

Thats actually a great idea lol and quite smart of you. Further to that, I do suggest micro botox to be injected on top of the sutures. What are your type of scars and skin type?

Yes I might look into a micro Botox as well

Im now seriously looking at this procedure and potentially co2 laser after, how long would you recommend I wait and what laser would be best. This is my plan at the moment any comments would be greatly appreciated.

2 minutes ago, Scarsmakemewanttodie said:

Im now seriously looking at this procedure and potentially co2 laser after, how long would you recommend I wait and what laser would be best. This is my plan at the moment any comments would be greatly appreciated.

That™s an interesting plan you have there. doing laser a week after the excision sutures are taken out is ideal, because it will also improve the PIH from the excision, though I wonder how much PIH you will get with your skin type. Why are you waiting until November for the excision?

1 minute ago, Catharsis2018 said:

Thats an interesting plan you have there.doing laser a week after the excision sutures are taken out is ideal, because it will also improve the PIH from the excision, though I wonder how much PIH you will get with your skin type. Why are you waiting until November for the excision?

Im at university currently and then have my sisters wedding so just waiting for a convenient time, as well as trying to do it in the winter months to have less UV and not wasting the best of the weather. I emailed a top plastic scar surgeon in the UK who specialises in cyst and mole removal. Who recommended a ellipse excision with internal stitches, normal stitches a botox soloution with steristripes and micropoor and muscle numbing on cheek for a week. Kinda of temporarily relaxing all the muscles on that cheek to reduce movement and promote better healing. He offered to do this for 500 if I accepted to be filmed and used as an example for his other patients. I then negotiated him up to 700 with a clause that if a if the scar is noticeable he would repeat this process and that I have free speech when discussing his procedure along side one year of my email being accessible on his website as a contact for future patients. This is potentially all part of my plan with my parents to create a charity within the UK that will help to fund cosmetic surgery for young adults and teenagers.

This is something that is very close to me as I feel ever so privileged to have the money to look into this and not have to many financial repercussions. However in my time on the internet researching I've spoke to many that have spent thousands on hunting for a better life when they really couldn't afford it. My aim is to allow those with the most disfiguring scars to be able to access treatments within the UK that are deemed cosmetic by the NHS without having to sacrifice there quality of life by spending extortionate amount of money on pointless social media dermatologist treatments.

On 8/27/2021 at 2:40 AM, Catharsis2018 said:

Punch excision was pretty life changing for me tbh. Check out my thread and let me know if you have questions.

did your doc use or a tool to do your punch excision or a scalpel?

12 hours ago, Catharsis2018 said:

Thats an interesting plan you have there.doing laser a week after the excision sutures are taken out is ideal, because it will also improve the PIH from the excision, though I wonder how much PIH you will get with your skin type. Why are you waiting until November for the excision?

Whats the theory on micro Botox on excision sites, does that help in not indenting or making it such that excision site does not open up? Any studies to be pointed.

7 hours ago, dirigo39 said:

did your doc use or a tool to do your punch excision or a scalpel?

He used a tool, the same used for skin biopsies etc

5 hours ago, getsmart121 said:

Whats the theory on micro Botox on excision sites, does that help in not indenting or making it such that excision site does not open up? Any studies to be pointed.

The theory behind it is that it minimizesthe chances of the excision site reopening and that it minimizes the chances of a hypertrophic scar forming. Why is that? Simplybecause youre essentially paralyzing the muscle with the neurotoxin, temporarily. My derm said there have been studies but I didnt fact check him on it

logically, it stands.

and cost wise is minimal, since a unit to each suture site 10/unit usually, can do The math

it especially made sense for me at the time since my scarring is in the cheeks only, and the zygomatic muscle is highly dynamic, used in talking/facial expressions/chewing etc

Im aware I pm you about this but feel everyone should see the response, how was the final resulting scar was there any volume loss and would you recommend this a must for people with scars.

9 hours ago, Scarsmakemewanttodie said:

Im aware I pm you about this but feel everyone should see the response, how was the final resulting scar was there any volume loss and would you recommend this a must for people with scars.

I didnt notice any volume loss after the excision procedure. The majority of the excision scars slowly filled in in the coming weeks after the procedure, which was pretty awesome and self gratifying for me to see, muahahaa.

Though it did become harder to keep track of my excision spots with my subsequent treatments (Idid fully ablative erbium laser a week after the excision sutures were taken out, then restylane skinboosters (2 syringes) + TCA Cross 90% 1 1/2 month later, then the trio with Rullan 2 months after therestylane skinboosters (2 syringes) + TCA Cross 90%

i think excision is a must if you suffer from deep boxcars, like I did. I wasted thousands on treatments that did nothing for my boxcars. And my boxcars always bothered me the most because of the scary shadow enhancing effect. Hated it!

big Bonus: its quite empowering to have the scar tissue, which once haunted you,literally cut out, defeated on the dermatologists instrument table.preeeettttyyyy damn awesome.

On 8/29/2021 at 6:31 AM, Catharsis2018 said:

I didnt notice any volume loss after the excision procedure. The majority of the excision scars slowly filled in in the coming weeks after the procedure, which was pretty awesome and self gratifying for me to see, muahahaa.

Though it did become harder to keep track of my excision spots with my subsequent treatments (Idid fully ablative erbium laser a week after the excision sutures were taken out, then restylane skinboosters (2 syringes) + TCA Cross 90% 1 1/2 month later, then the trio with Rullan 2 months after therestylane skinboosters (2 syringes) + TCA Cross 90%

i think excision is a must if you suffer from deep boxcars, like I did. I wasted thousands on treatments that did nothing for my boxcars. And my boxcars always bothered me the most because of the scary shadow enhancing effect. Hated it!

big Bonus: its quite empowering to have the scar tissue, which once haunted you,literally cut out, defeated on the dermatologists instrument table.preeeettttyyyy damn awesome.

Once again I've been looking through medical journals, I've found this which seems to be extremely effective at reducing the resulting surgical scar that comes as a result of the excision. Its name is pixel RF, its a reasonably new technology which is said to be more efficient at surgical scars than traditional ablative laser. I'm unsure on official pricing but according to the manufacturers website its a cheaper piece of equipment without consumables therefore should be a cheaper procedure am I right. Here is the link to the medical journal https://link.springer.com/chapter/10.1007/978-3-030-44766-3_53 . Let me know what you think?

On 8/27/2021 at 6:59 PM, Scarsmakemewanttodie said:

Im at university currently and then have my sisters wedding so just waiting for a convenient time, as well as trying to do it in the winter months to have less UV and not wasting the best of the weather. I emailed a top plastic scar surgeon in the UK who specialises in cyst and mole removal. Who recommended a ellipse excision with internal stitches, normal stitches a botox soloution with steristripes and micropoor and muscle numbing on cheek for a week. Kinda of temporarily relaxing all the muscles on that cheek to reduce movement and promote better healing. He offered to do this for 500 if I accepted to be filmed and used as an example for his other patients. I then negotiated him up to 700 with a clause that if a if the scar is noticeable he would repeat this process and that I have free speech when discussing his procedure along side one year of my email being accessible on his website as a contact for future patients. This is potentially all part of my plan with my parents to create a charity within the UK that will help to fund cosmetic surgery for young adults and teenagers.

This is something that is very close to me as I feel ever so privileged to have the money to look into this and not have to many financial repercussions. However in my time on the internet researching I've spoke to many that have spent thousands on hunting for a better life when they really couldn't afford it. My aim is to allow those with the most disfiguring scars to be able to access treatments within the UK that are deemed cosmetic by the NHS without having to sacrifice there quality of life by spending extortionate amount of money on pointless social media dermatologist treatments.

This doctor seems to really know what they are doing and have a process. My excision was botched with just a rough regular stitching. I truly believe the key as with MOHS surgeries are the sutures that are dissolvable underneath and the over the skin stiches (regular). I think that is why mine sunk so badly - it was looking for tissue to connect with underneath. He took such an aggressive chunk out and just did a rough 6 stitches on the apple of my cheek - who does that? And yes, did my research - a top plastic surgeon nearly 5 stars, so many great reviews.